Would you attempt a vaginal delivery for a breech baby?
I ask because there is one OB who vaginally delivers breech babies in my city. (This is him, https://www.pbs.org/wnet/religionandethics/episodes/august-14-2009/dr-t/3115/ He's actually quite an amazing man!). He's also incredibly supportive of VBAC, even VBAC after multiple cesareans so a large number of the women on my local ICAN board are his patients.
From what I've read, breech deliveries (esp. certain breech presentations) aren't really that much more difficult or complicated than some of the vertex presentations (sunny side up for example) BUT it's become a lost art because of the tendency of maternal care in the US to err on the side of c-section. Not to mention most OBs haven't been present for a breech delivery let alone attended one.
So out of curiosity, assuming you had a breech skilled attendant, would you attempt to deliver a breech baby vaginally?
Re: Would you attempt a vaginal delivery for a breech baby?
I think it would depend on what type of breech. I mean really a baby butt is pretty much the same size as their head when they are bent in half. And as long as your care provider is experienced with them I would feel like I was in good hands.
I think the reason that most docs wont touch a breech is because they have to be "hands off" and just let it happen, and they just arent taught to do that anymore. They are taught to DO something kwim?
I agree with this. I don't know a whole lot about breech births, but I do know that there are private midwives who will assist in such cases. I think i remember reading that they do breech births on the Farm. I think I would definitely consider trying a breech birth if my provider were experienced with it - and this doc seems to be an expert.
Also, my DD was sunny side up, too, with both hands at her cheeks, giving me an extra few inches to push out! While it was not pleasant at all, there was no reason for her not to be born naturally. The labor was a bit longer than "normal," maybe (21 hours of active labor), but she was born without complication.
That's pretty cool about Doc T!
The midwife who delivered DS does vaginal breech deliveries. I trust her completely, so if she felt I was a good candidate for one, I'd seriously consider it. I'd have a lot of questions for her beforehand, though!
Mommy to DD1 (June 2007), DS (January 2010), DD2 (July 2012), and The Next One (EDD 3/31/2015)
Absolutely! But I'm pretty sure around here if baby is breech, it's not even an option.
Mine's breech currently but it's still early. We'll have to see.
Oh, and I know I read footling breech is nearly impossible, but butt first is okay, so I suppose that would make a difference.
absolutely! there is only one doctor here in the DC area who is skilled at breech deliveries. i have met him and he is an amazing person. i would absolutely have my baby with him, if i needed an OB. my MW is also trained in breech vaginal deliveries, so the OB option would only be exercised if there were some complication. i don't consider breech presentation to be a complication. it's not ideal presentation, but it is also not a ocmplication.
and, i totally agree wtih OPs assessment of why breech deliveries are no longer standard. it's really quite shameful. so many mams cut for no reason.
also, i've read that the risk of uterine rupture in a vbac is not significantly greater than the risk of uterine rupture in a c/s birth.
You are correct. (Believe me I read EVERYTHING before signing up for a VBAC) The risk of rupture with a VBAC is very low and in fact there was just a study released that indicates the risk of rupture with a VBAC is equally as low as it is with a mom having her first delivery....
Here's info on the study:
https://www.ncbi.nlm.nih.gov/pubmed/20447886
BACKGROUND: Previous studies assessing the safety of vaginal birth after caesarean section (VBAC) have compared VBAC to elective repeat caesarean section (ERCS), despite the fact that the risks posed by each are considerably different. Explaining the complications of VBAC in a way that is meaningful to women can be challenging, and thus a comparison to a similar group of women who have also not undergone previous vaginal delivery may be a more relevant comparison.
RESEARCH QUESTION: When counselling women undergoing planned VBAC, should a comparison of outcomes be made to women undergoing ERCS, or is a comparison to other nulliparous women undergoing vaginal birth a more valid comparison in terms of risk outcomes?
PARTICIPANTS AND METHODS: A retrospective cohort study was undertaken comprising a consecutive cohort of 21,389 women who delivered, stratified by Robson's criteria into Robson groups 1-5. Those in Robson groups 6-10 were not included. Demographic data and maternal/neonatal outcomes were reviewed, with main outcome measures comprising uterine rupture, post-partum haemorrhage (PPH), 3rd/4th degree tears and neonatal morbidity.
RESULTS: There was no increase in postpartum hemohorage, vaginal tears or neonatal complications in the VBAC group when compared to Robson groups 1 and 2 (nulliparous women in spontaneous or induced labour, respectively). Uterine rupture rates were low in all groups, with no correlation identified.
DISCUSSION: The maternal and neonatal morbidity associated with VBAC is comparable to primiparous women undergoing a vaginal birth.
CONCLUSION: In demonstrating the low relative morbidity in this comparison, these outcomes may aid in counselling women faced with the choice of VBAC versus ERCS. Copyright ? 2010 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.
Sure! My MW delivers breech babies, so had that been the only issue with DD, I would have attempted a vaginal delivery. Unfortunately, with as low as her fluid was, my MW didn't think she would make it through a vaginal birth and I was sent immediately for a c/s after my BPP determined the fluid levels. Well, almost immediately. My MW & I sat in the office and cried for a good 20 minutes before we headed to the hospital. lol
A thin uterus doesn't necessarily mean a rupture was imminent. VBAC is safe. I don't know why people like you continue to insist that it isn't, in spite of mountains of evidence. Even VBAC after multiple cesareans can be done safely. The odds of rupture in a VBAC are around the same as the odds of an emergency in the general laboring population--on par with things like prolapsed cord. So by your logic, if that is an unacceptable risk level, no one should ever deliver vaginally.
Except that you also have the same level of risk in a cesarean section--different risks, but risks all the same. So I guess no one should ever have babies LOL.
I am not saying everyone should choose VBAC. It just makes me angry when people act like VBAC is SOOO dangerous and scare women away from it, when it's actually very safe.
Exactly. Birth risks are six of one, a half dozen of the other, depending on your method. Personally I've found the ever so slightly increased risk of rupture to be less off-putting than the full page of "what if's" that I had to sign off on with my c/s consent.
This. I'm sure it must be traumatizing to see a birth go wrong but that's why it is so important to look at studies where many women are evaluated. It's the only thing that allows us to measure the true risk. It would be traumatizing to see a horrific car accident but we still get behind the wheel each day. We know there's a risk each time but it is a calculated risk that we're comfortable with, ya know.
Yep, there is always talk about the risks of VBAC, but you hardly ever hear the risks of repeat cesarean, especially to the mother. The baby is not the only person who matters. My health matters too and I am allowed to consider that without being selfish. Not to mention, I have a child already who needs a healthy mother.
OP sorry to derail your thread, I know this was supposed to be about breech births, not VBAC.
i'm a doula in atlanta, and my group works with dr. t a lot. in fact, one of my clients just had a vaginal breech delivery two weeks ago! tate is awesome, and i would do it in a heartbeat.
feel free to email me if you want to talk more!
mjsmomma07 at gmail.
~Working Mom~Breastfeeding Mom~Cloth Diapering Mom~BLW Mom~
Blog - No Longer on the DL ~ The Man Cave
Shawn and Larissa
LO #1 - Took 2 years and 2 IVFs ~ DX - severe MFI mild PCOS homozygous MTHFR (a1298c)
LO #2 - TTC 7 months, surprise spontaneous BFP!
Yes I absolutely would! And I will with this one if it comes time and that is how LO has decided to be. In fact Canada (I believe) just changed or is about to change it's medical policy on breech presentations and how they decide who "needs" a c-section and who can progress with vaginal delivery. They are planning a huge education campaign for doctors that were never taught this disappearing skill, as well as for current med students that would not currently be taught this.
My mother was a breech baby and my Nanny (grandmother) delivered her with a midwife in Ireland. I have no fear of breech because of this.
Fear of litigation. Thank the lawyers for this.
Yes I totally would. I know people who have had breeched babies naturally and I feel it is something that should not automatically equal a c-section. Yes they are complicated births but there are several types of births that are complicated and I still think the recovery of a c-section would be worse.
DS was breech. When we discovered (after my water broke) I asked the MW if she felt comfortable. She said she would have done it if there wasn't meconium. He did end up with MAS.
We also found out (afterwards obviously) that he was 9 lbs. MW was estimating him 7 lbs. So I guess in the end, I'm glad that I didn't attempt a breech birth with my first 9 lb MAS child.
But I would have done it if she had been comfortable. (We were at home, BTW)
Absolutely!! anything to avoid a c-section. Unless that were my only option of course. Luckily my MW is comfortable has attended other breeched deliveries so I am comfortable with making such decision.
This. If the risk of harm to my baby is not significantly greater one way or another, I'm always going to choose the most natural, least invasive method. And, I'm sorry, but cesarean is always going to be more invasive.
I was a double footling breech born vaginally. I basically slipped out while my mom was being wheeled to the operating room.
My shoulders did get stuck, so they put out an APB for all medical students in the hospital to come watch as the OB pulled my arms down. He said there was a slight risk that I would have trouble lifting my arms. I don't. I'm fine.
I would absolutely consider a vaginal birth for a breech baby.
THIS!!!!!!!!!!!!! I don't understand how we got so far away from letting a woman's body do what it's been doing for millions of years. It makes me angry that women have been lead to believe that there's so much they CAN'T do. It's sad. Enough with the intervention and paranoia!
Hell yes I would attempt a breech birth, I also have faith in my midwives and their experience. I was there when my godson was born and I was heartbroken when my cousin was induced after 3 days overdue and rushed through labour and when her dr said, "ok lets move this along I have rounds to make"....... quite a few choice colourful words came to mind. He acted like her 7 hour labour was borderline c/s worthy...asshat!!